S622 Methodological Quality of Clinical Practice Guidelines for the Management of Antithrombotic Agents in Patients Undergoing GI Endoscopy: A Systematic Critical Appraisal Using the AGREE II Tool
Notice bibliographique
Résumé
Introduction: Several published clinical practice guidelines (CPGs) exist for the management of antithrombotic agents in patients undergoing GI endoscopy. However, to date, the quality of such CPGs has not been systematically appraised. The goal of this study was to identify and evaluate the quality of CPGs for the management of antithrombotic agents in peri endoscopic period published within last 6 years. Methods: A systematic search of PubMed and Embase database was performed to identify eligible CPGs. Any CPGs published between January 1, 2016 and April 14, 2022 addressing management of antithrombotic agents in patients undergoing GI endoscopy were eligible. The Canadian Agency for Drugs and Technologies in Health (CADTH) broad filter for the CPG terms was used since it is the most sensitive filter. The quality of the CPGs was independently assessed by five reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. Domain scores were considered of sufficient quality when >60% and of good quality when >80%. Results: The search yielded 343 citations of which 7 were CPGs and included for the critical appraisal (Table) (one CPG was published in two journals). Five CPGs were published by the gastroenterology associations in Europe (n=2) and Asia (n=3) and two in the United States. The overall median score for the AGREE II domains was 100% for scope and purpose, 72% for stakeholder involvement, 86% for rigor of development, 100% for clarity of presentation, 29% for applicability and 89% for editorial independence. Table presents scores for the AGREE II domains for each included CPG. Conclusion: The findings from our study show that the overall methodological quality of the CPGs for the management of antithrombotic agents in patients undergoing GI endoscopic procedures varies across various domains. Only one CPG included patient representatives in the CPG development process. There is a significant scope for improvement for methodological rigor and the applicability. Table 1. - Clinical practice guidelines included in the critical appraisal using AGREE II instrument. Authors Title Journal AGREE II scores [%] Scope and purpose Stakeholder involvement Rigor of development Clarity of presentation Applicability Editorial independence Overall Acosta et al. The management of antithrombotic agents for patients undergoing GI endoscopy Gastrointest Endosc 2016 Jan;83(1):3-16. doi: 10.1016/j.gie.2015.09.035. 100% 29% 64% 100% 14% 57% 64% Kato et al. Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment: 2017 Appendix on Anticoagulants Including Direct Oral Anticoagulants Dig Endosc. 2018 Jul;30(4):433-440. doi: 10.1111/den.13184. 100% 57% 64% 86% 29% 79% 61% Chan et al. Management of patients on antithrombotic agents undergoing emergency and elective endoscopy: joint Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) practice guidelines Gut 2018 Mar;67(3):405-417. doi: 10.1136/gutjnl-2017-315131 100% 86% 79% 100% 14% 100% 73% Farcas et al. Gastrointestinal endoscopy in patients on direct oral anticoagulants. A consensus paper of the Romanian Society of Gastroenterology and Hepatology J Gastrointestin Liver Dis. 2018 Jun;27(2):179-187. doi: 10.15403/jgld.2014.1121.272.end. 100% 57% 71% 71% 29% 86% 61% Lim et al. Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy Clin Endosc. 2020 Nov;53(6):663-677. doi: 10.5946/ce.2020.192 100% 86% 100% 100% 29% 100% 85% Veitch et al. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update Endoscopy. 2021 Sep;53(9):947-969. doi: 10.1055/a-1547-2282 100% 100% 100% 100% 43% 100% 90% Abraham et al. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period 1. J Can Assoc Gastroenterol.2022 5(2):100-101. doi: 10.1093/jcag/gwac010.2. Am J Gastroenterol 2022 117(4):542-558. doi:10.14309/ajg.0000000000001627. 100% 100% 100% 100% 57% 93% 83%
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,337 | 0,673 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,012 | 0,012 |
| Bibliométrie | 0,031 | 0,025 |
| Études des sciences et des technologies | 0,003 | 0,005 |
| Communication savante | 0,007 | 0,005 |
| Science ouverte | 0,004 | 0,005 |
| Intégrité de la recherche | 0,004 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; l’étiquette directe de Gemma et le classifieur distillé Codex s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».